Insurance companies are concerned that some people are abusing the Special Enrollment Period (SEP) that is available in the individual marketplace. They have indicated at least some people are delaying enrollment in coverage until they get sick, applying for coverage only once they need it, and then canceling the coverage after treatment. They further argue that there aren’t enough rules in place to verify if a person actually experienced a qualifying event which would trigger a SEP.

The Department of Health and Human Services (HHS) issued some new guidance on May 2, 2014 as it relates to Special Enrollment Periods and Hardship Exemptions in the individual marketplace. The new guidance has been summarized below: